Medacs Healthcare

OCT 16/2014

Medacs Healthcare Ebola Virus Guidance

Medacs Healthcare would like to draw your attention to  the current Public Health England guidance in relation to the Ebola Virus. Please click here to keep up to date with the latest developments.

In addition, we have created some supporting guidance in relation to healthcare professionals working through Medacs Healthcare.

What is Ebola?

The Ebola virus causes an acute, serious illness which is often fatal if untreated. Ebola virus disease (EVD) first appeared in 1976 in two simultaneous outbreaks, one in Nzara, Sudan, and the other in Yambuku, Democratic Republic of Congo. The latter occurred in a village near the Ebola River, from which the disease takes its name.

The current outbreak in West Africa, (first cases notified in March 2014), is the largest and most complex Ebola outbreak since the Ebola virus was first discovered in 1976. There have been more cases and deaths in this outbreak than all others combined. It has also spread between countries starting in Guinea then spreading across land borders to Sierra Leone and Liberia, by air (one traveller only) to Nigeria, and by land (one traveller) to Senegal.

The most severely affected countries, Guinea, Sierra Leone and Liberia have very weak health systems, lacking human and infrastructural resources, having only recently emerged from long periods of conflict and instability. On August 8, the WHO Director-General declared this outbreak a Public Health Emergency of International Concern.

A separate, unrelated Ebola outbreak began in Boende, Equateur, an isolated part of the Democratic Republic of Congo.

Transmission

It is thought that fruit bats of the Pteropodidae family are natural Ebola virus hosts. Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals such as chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest.

Ebola then spreads through human-to-human transmission via direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (eg bedding, clothing) contaminated with these fluids.

Healthcare workers in the affected areas have frequently been infected while treating patients with suspected or confirmed EVD. This has occurred through close contact with patients when infection control precautions are not strictly practiced. Burial ceremonies in which mourners have direct contact with the body of the deceased person can also play a role in the transmission of Ebola.

People remain infectious as long as their blood and body fluids, including semen and breast milk, contain the virus. Men who have recovered from the disease can still transmit the virus through their semen for up to seven weeks after recovery from illness.

Symptoms of Ebola virus disease

The incubation period, that is, the time interval from infection with the virus to onset of symptoms is 2 to 21 days. Humans are not infectious until they develop symptoms. First symptoms are the sudden onset of fever fatigue, muscle pain, headache and sore throat.

This is followed by vomiting, diarrhoea, rash, symptoms of impaired kidney and liver function, and in some cases, both internal and external bleeding (e.g. oozing from the gums, blood in the stools). Laboratory findings include low white blood cell and platelet counts and elevated liver enzymes.

Risk of infection within the UK

The likelihood of catching Ebola virus disease is considered very low unless you've travelled to a known infected area and had direct contact with a person with Ebola-like symptoms - there has been just one imported case of Ebola in the UK. While it is possible that more people infected with Ebola could arrive in the UK on a plane, the virus is not as easily transmitted as a respiratory virus such as influenza.

In past outbreaks, infection control measures have been very effective in containing Ebola within the immediate area. The UK has a robust public health system with the trained staff and facilities necessary to contain cases of Ebola. Advice has been issued to the Border Force to identify possible cases of Ebola and there are procedures in place to provide care to the patient and to minimise public health risk to others. Also, Ebola victims do not become infectious until shortly before they develop symptoms. The disease then progresses very rapidly. This means infectious people do not walk around spreading the disease for a long period.

It typically takes 5-7 days for symptoms to develop after infection, so there is time to identify people who may have been exposed, put them under surveillance and if they show symptoms, quarantine them.

Flight crew are trained to respond swiftly to any passengers who develop symptoms during a flight from Africa. They will take measures to reduce transmission on board the plane. But this event is very unlikely, and so far there have been no documented cases of people catching the disease simply by being in the same plane as an Ebola victim.

What if I think I might have Ebola in the UK?

If you feel unwell with symptoms such as fever, chills, muscle aches, headache, nausea, vomiting, diarrhoea, sore throat or rash within 21 days of coming back from Guinea, Liberia or Sierra Leone, you should stay at home and immediately telephone 111 or 999 and explain that you have recently visited West Africa. These services will provide advice and arrange for you to be seen in a hospital if necessary so the cause of your illness can be determined.

There are other illnesses that are much more common than Ebola (such as flu, typhoid fever and malaria) that have similar symptoms in the early stages, so proper medical assessment is really important to ensure you get the right diagnosis and treatment. It is also really important that medical services are expecting your arrival and calling 111 or 999 will ensure this happens.

References; 

World Health Organisation; www.who.int/csr/disease/ebola/en

Department of Health; https://www.gov.uk/government/organisations/department-of-health

Public Health England; https://www.gov.uk/government/organisations/public-health-england

Previous: Medacs Healthcare Launch Career Support Package for Doctors

Next: New locum doctors career centre

Announcements

Read More

Latest Blog Posts

Read More